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Ending infant and pre-term deaths

INFANT mortality remains one of Nigeria’s major health challenges. The country ranks the highest in Africa in terms of the number of neo-natal deaths and is second globally after India. Newborn deaths contribute to 32 per cent of mortality under five years. Each year an estimated 240,000 newborn babies die in their first month of life out of an estimated seven million annual deliveries or around 650 per day. In addition there are about 314,000 stillbirths annually.

One of the contributors to high rate of newborn deaths is pre-term or premature birth. A premature or pre-term is a birth that takes place more than three weeks before the baby is due, that is, before the start of the 37th week of pregnancy. Normally, a pregnancy lasts about 40 weeks. Pre-term birth gives the baby less time to develop in the womb and is the leading cause of death for babies in the first month of life.

In Nigeria, every year, an estimated 1 million babies are born pre-term and one in three newborn deaths is due to pre-term birth complications with almost 100,000 newborn deaths, equivalent to one in every eight babies born alive. Nigeria ranks No.3 in the world for this public health problem after India and China.

Prematurity has far-reaching impact on development and health of children and when they become adults. In Nigeria, babies born too soon are between six and 26 times more likely to die during the first four weeks of life than babies born at term.

Pre-term birth happens spontaneously for a number of reasons, due to early induction of labour or Caesarean birth, whether for medical or non-medical reasons. Other common causes include multiple pregnancies, infections and chronic conditions, such as diabetes and high blood pressure. There is also a genetic influence; often no cause is identified. Generally, babies born premature have reduced chances of survival and even when they survive, they are forced to contend with life-long ailments and conditions.

However, although these babies are born too soon, they are not born to die. Their deaths are preventable and up to 75 percent could be saved without expensive, high technology care. The World Health Organisation (WHO) is helping to highlight pre-term birth as a global priority, and has helped in pushing for its inclusion within the post-2015 sustainable development agenda to sustain global effort to raise awareness of the deaths and disabilities due to prematurity and promote the simple, proven, cost-effective measures that could prevent them.

The world is moving ahead in premature care and Nigeria must move along. Enough should be done to remember this vulnerable group. Many of these deaths are avoidable, through both prevention of pre-term birth, and provision of care for the premature baby. More action must be taken to raise awareness of what can be done to reduce the challenge of pre-term births and ensure better care for babies born too soon. Many premature babies die as a result of delay and other unhealthy processes they go through before adequate care reaches them.

The extra care being given to women should take on a new role. The major benefits of safe motherhood, family planning strategies, birth spacing and adolescent-friendly services, should be available and accessible to help in reducing the risk of pre-term birth. Pregnant women should be encouraged to attend antenatal and postnatal care, while nursing mothers should adopt early initiation and exclusive breastfeeding. Access to skilled care at delivery, can help to reduce deaths due to pre-term birth. All hands should be on deck to effectively combat the challenge of prenatal death and foster better survival of babies born prematurely.


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